Comparison of effects of oral methylprednisolone with oral prednisolone in Acute Exacerbations of COPD

Abstract

Background: Exacerbations are common in Chronic Obstructive Pulmonary Disease. Corticosteroids are the mainstay of therapy for treatment of acute exacerbation of COPD. In the present study we compared the effects of 32mg oral methylprednisolone and an equivalent dose of 40mg oral prednisolone in patients with AECOPD. Methodology: This was an analytical, experimental study conducted on 44 inpatients of AECOPD at a tertiary care centre in central India over a period of one and a half years. Patients were divided into two groups: Group A received 32mg methylprednisolone and Group B received 40 mg prednisolone for five days. Results: Both methylprednisolone and prednisolone were equally effective in relieving AECOPD symptoms at the end of day 5 (Group A: 72.2% vs Group B: 86.4%, p = 0.26). Mean length of hospital stay was similar in both the groups (Group A: 9.09 days vs Group B: 8.77 days, p = 0.68). There was no difference in the number of patients who failed treatment in both the groups (Group A: 72.7% vs Group B: 86.4%, p>0.26). The number of days on O2 was similar in both the groups (Group A: 5.55 days vs Group B: 5.14 days, p = 0.46 ). O2 free days was also similar in both the groups (Group A: 3.55 days vs Group B: 3.64 days, p = 0.64). Majority of the patients did not have any adverse effect (Group A: 59.9% vs Group B: 72.7%, p = 0.051). Conclusion: Prednisolone and Methylprednisolone had similar effects in AECOPD.